2001, 05-23 Notice of Unsatisfactory ConditionBUILDING AND CODE ENFORCEMENT
James L. Manson, C.B.O., Director
May 23, 2001
Paul Scott
S 2709 Dishman Mica
Spokane, WA 99206
RE: Notice of Unsatisfactory Condition - Gas Piping
Dear Mr. Scott:
A DIVISION OF THE PUBLIC WORKS DEPARTMENT
Gary Oberg, Director
Our office has been informed that an unsatisfactory condition may exist with regard to the exterior gas piping
located at the referenced address.
This notice is to inform you that should you install new equipment, you must obtain a permit.
Should you have any questions, please contact this office between the hours of 8:00 a.m. and 4:00 p.m. Our phone
number is: (509) 477-3675.
der
Sincerely,
�t +�
C, ax I
Diane Truax
Office Assistant 1V
1026 W. BROADWAY • SPOKANE, WASHINGTON 99260-0050
PHONE: (509) 477-3675 • FAX: (509) 477-4703 • TDD: (509) 477-7133
Aouifir/STA NOTICE OF UNSATISFACTORY CONDITIONS
Utilities((? r�
Customer Name ! A ✓ c-' (/ Phone Number fZ =j
Address =
0 1)!' 1)1_41 kW 44,1 lib.( ti City p[ Gi.14...4
TYPE OF
NOTIFICATION:
Equipment Type:
CONDITIONS ❑ Apparent cracked or restricted heat exchanger
❑ Spillage of exhaust at the draft hood after a
reasonable warm-up time
❑ Damaged appliance connector
❑ Damaged or disconnected vent
❑ Defective limit control
❑ A gas leak in your house piping in the amount of
with all known appliances off
S-0308 (1-99)
7
❑ HAZARD The conditions noted below constitute an immediate hazard and may result in property damage, personal injury, or loss
of life. The equipment has been turned off pending further inspection and repairs, and shall not be turned back on until such repairs have
been completed by a qualified HVAC dealer, contractor, or service agency, and the equipment has been brought up to current safety
standards. Do not attempt to use this equipment until it has been repaired.
,WARNING The conditions noted below constitute a potential hazard. Although the condition does not present an immediate
threat to life or property, failure to correct the condition may lead to a hazardous condition. Please contact a qualified HVAC dealer,
contractor, or service agency to perform further inspections or to bring the equipment up to current safety standards.
Location•
FOUND:
I have read, understood and acknowledge receipt ofthis notice.
Customer Signature
❑ Owner
CFH
❑ Inoperative safety system
❑ Insufficient combustion/ventilation air
❑ Gas leak at gas equipment
❑ Other
❑ Tenant ❑ Agent
Service Representative
Equipment Disconnected? ❑ Yes ,$j No Equipment Tag Left?
Equipment Left ❑ On ❑ Off Meter Left ❑ Off L7, On
White Copy -Customer Yellow Copy- Attach to Service Order
❑ Yes
D ate
,.r
❑ Refused to Sign
Time - - 0 am/pm
❑ No Authority Notification Required? ❑ Yes ❑ No
Pink Copy- Authority Having Jurisdiction Hard Copy -Appliance